Surgical management of strabismus after rupture of the inferior rectus muscle

Background: Rupture of an inferior rectus muscle is an uncommon problem. Th e resulting absence of infraduction and large hypertropia that result when the muscle cannot be repaired are challenging to manage surgically. Methods : We treated 2 patients who had traumatic rupture of the inferior rectus mu scle, Both patients underwent an inferior transposition of the inferior hal ves of the medial and lateral rectus muscles without disinsertion (modified Jensen transposition procedure). Results: Both patients had a persistent s mall overcorrection in the primary gaze position. One patient was treated w ith a second strabismus surgery consisting of a recession of the contralate ral superior rectus muscle; the other was treated with prism glasses, Both achieved restoration of depression to approximately 40 degrees and single b inocular vision in the primary position at distance, near, and in the readi ng position, Conclusion:This modified Jensen transposition procedure of the horizontal rectus muscles appears to be highly effective in the treatment of the hypertropia and infraduction deficit produced by rupture of the infe rior rectus muscle. It also appears to be suitable for use in situations wh en other rectus muscles are absent or unavailable for surgical manipulation .